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T J Coleman

Publications and source records attributed to T J Coleman.

At least 19 recordsLinked to original sources
PubMed2000

The public health laboratory service (PHLS) and its role in the control of zoonotic disease.

The aetiology of zoonotic infections embraces organisms from every branch of the microbial world. In addition, zoonoses must be considered as a truly global problem, both in terms of their distribution and the measures required for their control. Within the UK, zoonotic disease is considered to be less frequent than in some less developed parts of the world. However, its contribution to overall morbidity and mortality within the UK population is not well established. In an attempt to define the impact of zoonotic infection more accurately, a multicentre prospective study of disease in farmers in England and Wales was initiated by the PHLS in 1992. The study involved the completion by participants of annual questionnaires dealing with their own health and the range and health of their livestock. Our results confirmed that some infections occur frequently in farmers. For example, ringworm and Q fever were associated with contact with cattle and orf with the handling of sheep. Some findings were unexpected; the incidence and prevalence of leptospirosis, for example, were far lower in the farmers than had been anticipated, whilst there was a higher than expected incidence and prevalence of hantavirus infection. The success of the project was largely due to the adoption of a multidisciplinary approach and the continuity of funding which enabled the study of the same cohort to continue for 7 years.

Animals↗
PubMed1999

Orf (contagious pustular dermatitis) in farmworkers: prevalence and risk factors in three areas of England.

Orf is a zoonotic skin disease which is commonly self-diagnosed by those who tend sheep and goats. This paper reports the prevalence, incidence and risk factors associated with the infection in a cohort of farmworkers from three areas of England, derived from the results of self-reporting and serology. Twenty-three per cent of those employed or living on a sheep farm reported ever having had orf, and the antibody serological profiles indicated a prevalence of 4 per cent and an annual incidence of 2.8 per cen. The main risk factors associated with the infection were contact with sheep, the size of the sheep flock, and contact with dogs.

Animal Husbandry↗
PubMed1998

Low rates of ehrlichiosis and Lyme borreliosis in English farmworkers.

To determine the occupational significance of tick-borne zoonoses we sought serological evidence of Lyme borreliosis, human monocytic ehrlichiosis (HME) and human granulocytic ehrlichiosis (HGE) in a representative sample of farmworkers. Although around 20% reported ticks on their domestic and companion animals, few (< 2% per year) reported being bitten by ticks. Seroprevalence of Lyme borreliosis (0.2%), HME (0.2%) and HGE (1.5%) was low. Those seropositive for HGE were no more likely to report tick bites nor more likely to report ticks on their animals. This study provides evidence that farmworkers in England are exposed to tick-borne zoonoses but that they are uncommon. Since the severity of these diseases is linked to delays in diagnosis and treatment, clinicians should be aware of these diagnoses in patients from rural communities, with or without a self-reported history of tick bite.

Adult↗
PubMed1998

How well do viruses survive during transport?

Centralisation of viral diagnostic services offers the potential for cost saving in laboratories, but incurs costs for transporting specimens. In a trial of 326 paired specimens, isolation rates of viruses sent by overnight post and a more expensive same-day courier service were similar.

Body Fluids↗
PubMed1996

Risk factors for Neisseria meningitidis carriage in a school during a community outbreak of meningococcal infection.

As part of the management of an outbreak of meningococcal infection, 119 school contacts of an index case were swabbed for nasopharyngeal carriage. In a cohort study, risk factors for Neisseria meningitidis carriage were ascertained by means of a questionnaire, completed by 114 (96%) of those swabbed. Twenty five (21%) cultures were identified as "neisseria positive'; of which there were 18 (15%) Neisseria meningitidis isolates, 2 (2%) Neisseria lactamica isolates and 5 (4%) showed contaminants only. Two (2%) carriers were identified as harbouring the implicated outbreak strain. Single variable analysis identified six statistically significant risk factors for meningococcal carriage; increasing age, female sex, manual social class, personal smoking, regular attendance at a discotheque and rhinorrhoea. Multivariate analysis, using logistic regression modelling, found that of these six variables only age, sex and social class remained statistically significant when the other factors were controlled for. Nevertheless the role of smoking, social events and respiratory/viral infections in nasopharyngeal carriage, and other plausible mechanisms whereby age, sex and social class might exert their effect, could usefully be investigated further.

Adolescent↗
PubMed1995

Antibody responses and reactions to the whole cell pertussis component of a combined diphtheria/tetanus/pertussis vaccine given at school entry.

To measure the clinical effect of adding a whole cell pertussis component to diphtheria/tetanus vaccine (DT) given as a pre-school booster, 190 children aged 4-5 years were randomised by a double-blind method to receive either diphtheria/tetanus/pertussis (DTP) or DT vaccine in a 1:1 ratio at selected clinics in England. The geometric mean antibody titres to each of the three pertussis antigens were at least sixfold higher in the DTP than the DT vaccine group and equalled or exceeded those in infants immediately after primary immunisation with DTP vaccine. There were no significant differences between DTP and DT vaccinated children in their diphtheria and tetanus antitoxin levels. The frequency of large local reactions and systemic symptoms such as crying and a disturbed night was 2-3-fold higher in the DTP vaccinees than in the DT vaccinees. Medication was given to 44% of DTP and 23% of DT vaccinees (p = 0.006). Although the change to whole cell DTP vaccine at school entry would result in good pertussis antibody titres, the 2-3-fold increase in reactogenicity that would be caused may be unacceptable at a time when whooping cough is not circulating widely. Evaluation of acellular DTP vaccines given as a pre-school booster in children vaccinated under the accelerated schedule is planned.

Antibody Formation↗
PubMed1995

Adverse events and antibody response to accelerated immunisation in term and preterm infants.

A study was performed to compare adverse events and antibody response in term and preterm children vaccinated with diphtheria, tetanus, and pertussis vaccine at 2, 3, and 4 months of age. A total of 124 children were recruited and grouped according to gestational age: 37 weeks or more (n = 52), 34 to 36 weeks (n = 40), and less than 34 weeks (n = 32). Study nurses followed up children 24 hours after each vaccination to record temperature, redness, and swelling at the injection site and any systemic symptoms. Proportions of children experiencing adverse events did not differ between groups. Blood samples were obtained six weeks after the vaccination course at which time all children had protective levels of diphtheria and tetanus antitoxins. Geometric mean antibody titres (95% confidence interval) to pertussis toxin were 2754 (2042 to 3715), 5495 (4074 to 7413), and 3690 (2951 to 4677), to filamentous haemagglutinin were 541 (282 to 1023), 951 (537 to 1698), and 614 (426 to 1023), and to agglutinogens 2 and 3 were 12,106 (6918 to 21,380), 21,330 (13,183 to 34,674), and 22,387 (15,136 to 33,113) in children born at a gestational age of less than 34 weeks, 34 to 36 weeks, and 37 weeks or more respectively. These findings support the current recommendations that preterm children are vaccinated at chronological age according to the national schedule.

Age Factors↗
PubMed1995

The risk of acquiring Q fever on farms: a seroepidemiological study.

OBJECTIVES: To determine the occupational risk of Q fever. DESIGN: Cohort study. SETTING: Community: five English local authority districts. SUBJECTS AND METHODS: Prevalence and incidence of immunoglobulin G (IgG) specific antibody to Coxiella burnetii phase II antigen was measured in a representative (study) cohort of farm workers in the United Kingdom, and detailed exposure data were collected. Also seroprevalence of Q fever in a (control) cohort of police and emergency service personnel was measured. RESULTS: Prevalence was significantly (P < 0.01) higher in the study cohort (105/385 v 43/395). During the first 12 month period after enrollment no seroconversions were found (upper 95% confidence limit: 1318/100,000/year). During the second 12 month period after enrollment two seroconversions were found, equalling an incidence of 813/100,000/year (95% confidence interval (95% CI) 98-2937/100,000/year). No association was found between seroprevalence and age. In the study cohort, extent of total contact with farm animals seemed more important than exposure to any specific animal: full time employees were more than four times more likely to be antibody positive than part time employees (P < 0.05). Exposure to cattle, but not sheep, goats, cats, raw milk, and hay (all reported sources of Q fever) was associated with being positive to Coxiella burnetii IgG by univariate analysis but this association was not independent of total farm animal contact. CONCLUSIONS: The risk of Q fever on livestock farms is related to contact with the farm environment rather than any specific animal exposure. The absence of an increasing prevalence with age suggests that exposure may occur as clusters in space and time (outbreaks).

Adolescent↗
PubMed1994

Zoonotic illness--determining risks and measuring effects: association between current animal exposure and a history of illness in a well characterised rural population in the UK.

STUDY OBJECTIVES: To recruit a representative sample of farmworkers, accurately quantify the range and extent of their animal exposures, and measure the associated risks of illness. DESIGN: Inception cohort. SETTING: The study was undertaken among farmworkers living in five local authority areas in the catchment of Hereford and Preston Public Health Laboratories, England. PARTICIPANTS: A quota sample of 404 people on 255 agricultural holdings took part. The holdings were selected at random from the Ministry of Agriculture, Fisheries and Food register. Altogether 58% of eligible subjects approached agreed to participate. MEASUREMENTS AND MAIN RESULTS: The sample had the same sex distribution as the 1991 census for those giving their occupation as agriculture. The mean age was significantly (p < 0.01) higher (44.6 years v 42.2 years) than that of those giving their occupation as agriculture, forestry or fishing in the census, although the modal range (45-59 years) was the same. At enrollment interviews, subjects individually reported contact with up to nine animal species (mode 4) out of 26 reported in all. Based on the numbers contacted and the frequency and intimacy of contact, scores on a ranked ordinal scale from 0-5 were constructed for each species and frequencies for each score were plotted. Subjects also reported past operations and serious illness. A history of pneumonia was significantly (p < 0.05) associated with a pigeon loft on the farm (relative risk (RR) 7.3) and attending farrowing pigs (RR 6.6), and one of leptospirosis with a rat problem on the farm (RR 28.1). Cattle contact was associated with a significantly lower likelihood (protective) of glandular fever (RR 0.19) and rheumatic or scarlet fever (RR 0.12). These effects were significantly related to rankings of the extent of exposure. CONCLUSIONS: It is possible to recruit a representative sample of farmworkers and measure their animal exposures in great detail. Among these exposures, associations with plausible risk factors for pneumonia and leptospirosis and apparently protective factors for glandular fever, scarlet fever, and rheumatic fever have been demonstrated, which further show a relationship between the extent of exposure and response. These findings can be tested further by examining the relationship of exposures to serological evidence of illness or by further prospective follow up of this and similarly well characterised cohorts, or both.

Adult↗
PubMed1991

How is the source of food poisoning outbreaks established? The example of three consecutive Salmonella enteritidis PT4 outbreaks linked to eggs.

Three consecutive outbreaks of Salmonella enteritidis PT4 occurred in Wales in 1989 in which epidemiological and microbiological investigation established eggs as the likely source although kitchen inspection and food preparation histories suggested other vehicles of infection. This paper examines the contribution of analytical epidemiology in attributing causation, with particular reference to those limitations which are regarded as inherent in epidemiological evidence. Such evidence, implicating eggs in the three outbreaks, fulfilled 6/7 widely accepted criteria for causation; data to assess the seventh were lacking. Collaboration between different agencies and professionals in investigating outbreaks is very important.

Disease Outbreaks↗
PubMed1985

Detection of rubella-specific IgM in subclinical rubella reinfection in pregnancy.

Seven cases of asymptomatic rubella reinfection in early pregnancy are described. In each, there was a history of exposure to a rubelliform illness and low levels of rubella-specific IgM subsequently appeared in the serum. Four of the women had been immunised, after having been shown to be susceptible to rubella, one had been immunised at school without previous antibody screening, and two were uncertain about immunisation. One pregnancy was terminated and rubella virus was not isolated from the products of conception. Six pregnancies went to term and the infants showed no evidence of intrauterine infection. In a further case it was impossible to discriminate between reinfection and primary infection, and termination of pregnancy was offered.

Adult↗